Kayla Lee Ellen Louise Bickford

Individual provider Active NPI Registered Nurse · Buffalo, MN

NPI 1669959508 · NPPES record last updated Jul 24, 2018

Key facts

NPI
1669959508
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
2461348 (MN)
Practice address
25 1St Ave NE Ste 100TH
Buffalo, MN 55313-1568
Phone
(763) 682-3005
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2461348MNMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2461348 MN Yes

Addresses

Primary practice location

25 1St Ave NE Ste 100TH
Buffalo, MN 55313-1568

Mailing address

25 1St Ave NE Ste 100TH
Buffalo, MN 55313-1568

Other providers in Buffalo, MN

All providers in Buffalo, MN · Registered Nurse in Minnesota

Sources for this page

Verify at the official NPI Registry.